Conscious Sedation Using Dexmedetomidine During Surgical Paddle Lead Placement Improves Outcome in Spinal Cord Stimulation: A Case Series of 25 Consecutive Patients

2020 ◽  
Author(s):  
Dimitri J. Vanhauwaert ◽  
Tim Couvreur ◽  
Anneleen Vandebroek ◽  
Olivier De Coster ◽  
Karel Hanssens
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Stimulation ◽  
Conscious Sedation ◽  
Case Series ◽  
Lead Placement

scholarly journals 10 kHz High-Frequency Spinal Cord Stimulation for Chronic Thoracic Pain: A Multicenter Case Series and a Guide for Optimal Anatomic Lead Placement

2020 ◽  
Vol 4;23 (7;4) ◽  
pp. E369-E376
Author(s):  
Dawood Sayed
Keyword(s):  
Spinal Cord ◽  
Back Pain ◽  
Spinal Cord Stimulation ◽  
High Frequency ◽  
Case Series ◽  
Functional Improvement ◽  
Thoracic Pain ◽  
Pain Scores ◽  
Lead Placement ◽  
Tonic Stimulation

Background: Surgical options for thoracic pain are limited and carry significant risk and morbidity. Spinal cord stimulation has the potential to be used for treatment of thoracic pain, as it has been useful for treating multiple types of chronic pain. Conventional tonic stimulation is limited in the treatment of thoracic pain, as it can produce paresthesia that is difficult to localize. Conversely, high-frequency spinal cord stimulation (HF-SCS) does not activate dorsal column Aβ fibers and does not produce paresthesia, and thus may be more beneficial in treating thoracic back pain not manageable with tonic stimulation. Objectives: To evaluate (1) the efficacy of 10 kHz HF-SCS for patients with chronic thoracic pain; and (2) appropriate paresthesia-free lead placement and programming targets for 10 kHz HF-SCS for patients with chronic thoracic pain. Study Design: Retrospective case series. Setting: Multisite academic medical center or pain clinic. Methods: A retrospective chart review was performed on 19 patients with thoracic back pain who underwent HF-SCS implantation. These patients had lead placement and stimulation between the T1-T6 vertebral levels. Outcome measures collected include location of device implant, stimulation settings, and pain scores at baseline, end of trial, and 1, 6, and 12 months postimplant. Followup phone calls collected information on if the patient reported functional improvement, improved sleep, or decreased pain medication usage. A Wilcoxon signed-rank test compared differences in mean pain scores across time points. Results: Significantly decreased Visual Analog Scale scores were observed with 17/19 (89.5%) patients demonstrating response to therapy (> 50% reduction in pain scores). These results were sustained relative to baseline at 1, 6, and 12 months postimplant, depending on length of followup. Many patients also reported functional improvement (17/19), improved sleep (14/19), and reduction in use of pain medications after implantation (9/19). A total of 15/19 patients reported best relief when contacts over T1 or T2 vertebrae were used for stimulation. Limitations: This study is limited by its retrospective design. Additionally, including documentation from multiple sites may be prone to selection and abstraction bias. Data were also not available for all patients at all time points. Conclusions: HF-SCS may be a viable option for significant, long-lasting pain relief for thoracic back pain. There may also be evidence for anatomically based lead placement and programming for thoracic back pain. Randomized, controlled trials with extended follow-up are needed to further evaluate this therapy. Key words: Thoracic pain, back pain, spinal cord stimulation, high frequency, 10 kHz

scholarly journals Successful application of burst spinal cord stimulation for refractory upper limb pain: a case series

2021 ◽  
Vol 49 (3) ◽  
pp. 030006052110040
Author(s):  
Kuen Su Lee ◽  
Yoo Kyung Jang ◽  
Gene Hyun Park ◽  
In Jae Jun ◽  
Jae Chul Koh
Keyword(s):  
Spinal Cord ◽  
Upper Limb ◽  
Spinal Cord Stimulation ◽  
Therapeutic Potential ◽  
Case Series ◽  
Limb Amputation ◽  
Intractable Pain ◽  
Limb Pain ◽  
Cord Injury ◽  
Upper Limb Pain

Spinal cord stimulation (SCS) has been used to treat sustained pain that is intractable despite various types of treatment. However, conventional tonic waveform SCS has not shown promising outcomes for spinal cord injury (SCI) or postamputation pain. The pain signal mechanisms of burst waveforms are different to those of conventional tonic waveforms, but few reports have presented the therapeutic potential of burst waveforms for the abovementioned indications. This current case report describes two patients with refractory upper limb pain after SCI and upper limb amputation that were treated with burst waveform SCS. While the patients could not obtain sufficient therapeutic effect with conventional tonic waveforms, the burst waveforms provided better pain reduction with less discomfort. However, further studies are necessary to better clarify the mechanisms and efficacy of burst waveform SCS in patients with intractable pain.

A Retrospective Case Series of High-Frequency Spinal Cord Stimulation (HF10-SCS) in Neurogenic Bladder Incontinence

2018 ◽  
Vol 17 (1) ◽  
pp. 14-20 ◽  
Author(s):  
Simon Schieferdecker ◽  
Clemens Neudorfer ◽  
Faycal El Majdoub ◽  
Mohammad Maarouf
Keyword(s):  
Spinal Cord ◽  
Neurogenic Bladder ◽  
Spinal Cord Stimulation ◽  
High Frequency ◽  
Case Series ◽  
Retrospective Case ◽  
Retrospective Case Series

Epidural anesthesia for surgical lead placement in spinal cord stimulation: special conditions

2009 ◽  
Vol 71 (1) ◽  
pp. 137
Author(s):  
M. Moens ◽  
A. De Smedt ◽  
J. D’Haese ◽  
B. Ampe ◽  
R. Ates ◽  
...  
Keyword(s):  
Spinal Cord ◽  
Epidural Anesthesia ◽  
Spinal Cord Stimulation ◽  
Lead Placement
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